氯吡格雷对不稳定型心绞痛患者血浆炎症因子和血小板活化因子的影响

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目的:探讨氯吡格雷对不稳定型心绞痛(ACS)患者血浆炎症因子和血小板活化因子的影响。方法:70例ACS患者随机分为两组,均按ACS治疗方案进行治疗,观察组在此基础上加用氯吡格雷75 mg,po,qd,连用8周。观察两组患者治疗前后血浆炎症因子hs-CRP、TNF-α、IL-6水平和血小板活化因子CD62p、CD63水平的变化。结果:两组患者治疗前血浆hs-CRP、IL-6和TNF-α水平比较,差异无统计学意义(P>0.05)。治疗8周后,两组患者血浆hs-CRP、IL-6和TNF-α水平均较治疗前明显下降(P<0.05或0.01),且观察组下降的幅度较对照组更明显(P<0.05)。两组患者治疗前血浆血小板活化因子CD62p和CD63水平差异无统计学意义(P>0.05),治疗8周后,两组患者血浆CD62p和CD63水平均较治疗前明显下降(P<0.05或0.01),且观察组下降的幅度较对照组更明显(P<0.05)。结论:氯吡格雷对ACS患者具有抗炎,抑制血小板活化作用,从而改善血管内斑块的炎症反应,减少血小板的黏附和聚集作用,在一定程度上增加动脉粥样斑块的稳定性、阻断和逆转冠状动脉粥样斑块作用。 Objective: To investigate the effect of clopidogrel on plasma inflammatory factors and platelet activating factor in patients with unstable angina pectoris (ACS). Methods: Seventy ACS patients were randomly divided into two groups and were treated by ACS. The observation group was given Clopidogrel 75 mg, po, qd for 8 weeks. The changes of plasma inflammatory cytokines such as hs-CRP, TNF-α, IL-6 and platelet-activating factor CD62p and CD63 before and after treatment were observed. Results: There was no significant difference in plasma hs-CRP, IL-6 and TNF-α levels between the two groups before treatment (P> 0.05). After 8 weeks of treatment, the levels of plasma hs-CRP, IL-6 and TNF-α in the two groups were significantly lower than those before treatment (P <0.05 or 0.01), and the decrease in the observation group was more significant than that in the control group (P <0.05 ). The plasma levels of CD62p and CD63 before treatment did not show significant difference between the two groups (P> 0.05). After 8 weeks of treatment, the plasma levels of CD62p and CD63 in both groups were significantly lower than those before treatment (P <0.05 or 0.01) , And the observation group decreased more significantly than the control group (P <0.05). CONCLUSION: Clopidogrel has anti-inflammatory and anti-inflammatory effects on patients with ACS, thereby improving the inflammatory reaction of intravascular plaque, reducing platelet adhesion and aggregation, and increasing the stability of atherosclerotic plaque to a certain extent Broke and reverse coronary atherosclerotic plaque.
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